Pages

February 11, 2016

Case Management: Is 40 Hours Enough?

One of the biggest challenges a case manager faces is time
management. There is so much to get done and so little time. In many
situations, quality is sacrificed just to get the work done in such tight
deadlines. Phone contacts, daily progress notes, scheduling meetings, and
addressing the occasional crisis can wipe out an entire day before you know it.
Many agencies can’t (or won’t) pay overtime to complete these tasks. So how in
the world do you get all of this work done and maintain quality when overtime
is not an option? This is one of the
major challenges facing many case management departments, especially in public
sector agencies.

Many case managers and social workers take work home when
they know they know it may be against the agency policies. It’s a choice
between getting the work done and breaking policy or not getting the work done
and face even worse consequences in addition to being further behind on
paperwork. A case manager can easily spend an entire work day doing home visits.
One crisis can actually take several days to resolve which leaves no time left
to actually document what you did. Of course everyone in the human services
field has heard the phrase “If it’s not written, it didn’t happen”. It often
takes time to recover from handling a crisis but you have to find the time to
complete basic tasks required by the agency. These required tasks such as
progress notes, quarterly reports, and treatment plans are usually tied to
funding and have to be done by specified timelines. There are some solutions
that seem pretty simple but can be difficult to implement due to budget constraints
and limited staffing. I have listed a few ideas that can help lighten the load.
However, these ideas are much easier said than done.

Increasing Staff

Hiring new staff can help with reducing the work load of the
current case managers. More staff includes not only case managers, but administrative
staff as well. Administrative staff can assist with filing and other
documentation so that case managers can focus on providing services to their
clients. Increasing staff will also
allow the agency to provide services to more consumers and increase revenue.
However, the cost of hiring and training staff will have to be taken into
account and ultimately absorbed before producing more revenue.

Reduce Caseloads

Increasing case management staff will provide an opportunity
to reduce caseloads. High caseloads are probably the second most complained
about issue behind excessive paperwork. A manageable caseload would help with
getting things done and getting it done with better quality. I can tell you a
caseload of 25 beats 35 any day. Most full time case managers in public agencies
average well over 30 cases. Again, a major stumbling block with reducing
caseload is the cost to bring in new staff to take on cases. New positions
often need to be approved by city council or other governing body for the
fiscal year. Another issue is wait
lists. Caseloads may be reduced but the relief could be short lived due to the
demand for services. In many states, case management is a mandated service to
the community.

Flex/Comp Time

Flex time is often used to offset when workers have to work
outside of normal work hours. An example would be an emergency that comes up at
4:45PM and it can’t be resolved until 6:00. The employee would then be able to
either come in an hour later or leave or leave and hour earlier the next day or
another day in the near future.

Comp time is often considered when there is a significant
deviation from the normal work schedule. In some situations such as emergency
shelter duty or special projects, comp time is offered in lieu of overtime pay.
Like flex time, comp time can be taken
off to make up for the extra work time. The problem with these options is that
the case managers often can’t afford to take the time off and get further
behind on their work. This is especially the case when comp time that is more
than eight hours.

Teleworking

Teleworking is also an option that can help case managers
get work done without the distractions that may come with working in the office
setting. Teleworking a couple of days a week can provide an opportunity to
dedicate time to completing paperwork.

I have seen each one
of these suggestions implemented in an effort to alleviate some of the workload
on case managers. The reality is that the nature of the job makes it difficult
to complete everything in a normal work week. Taking work home and working a more
flexible schedule is the only way to get it done. The old 9 to -5 schedule is too
restrictive in this age of increased responsibility and the mobile technology available
to help make the job easier.